Initial evidence for reliable and valid use of scores on the 8-item Econ-QOL short form to measure economic quality of life in caregivers of persons with traumatic brain injury

Published:August 06, 2022DOI:



      To provide reliability and validity data to support the clinical utility of Econ-QOL scores in caregivers of civilians and service members/veterans (SMVs) with TBI.


      Cross-sectional survey study.


      Three academic medical centers and a VA treatment facility.


      376 caregivers of civilians (n=213) and SMVs (n=163) with TBI.



      Main Outcome Measures

      Econ-QOL and several patient-reported outcome measures (TBI-CareQOL Caregiver-Specific Anxiety and Caregiver Strain, PROMIS Sleep-related Impairment, Neuro-QoL Positive Affect and Well-being) and measures of financial status (self-reported income).


      Internal consistency reliability of the Econ-QOL short form scores were excellent (all Cronbach's alphas ≥0.92). There were no floor or ceiling effects for scores. There was evidence of convergent and discriminant validity, with the Econ-QOL scores having the strongest relationships with self-reported income (convergent validity evidence), and weak relationships with the other measures (discriminant validity evidence). Individuals with scores that were “below or possibly below” the poverty line (according to 2016 Federal Government poverty level thresholds) reported worse economic QOL relative to those individuals that were definitely above the poverty line, supporting known-groups validity.


      This report establishes the clinical utility of scores on the Econ-QOL Short Form in caregivers of persons with TBI and provides evidence that it is valid and appropriate to use such scores not only in a variety of different disability populations (e.g., spinal cord injury, stroke) but also in caregivers.

      Key Words

      List of abbreviations:

      CAT (Computer Adaptive Test), ECON-QOL (The Economic Quality of Life Measure), HRQOL (Health-Related Quality of Life), PROMIS (Patient-Reported Outcomes Measurement Information System), Neuro-QoL (Neurological Quality of Life Measurement System), SMV (Service Member/Veteran), TBI (Traumatic Brain Injury), TBI-CareQOL (Traumatic Brain Injury Caregiver Quality of Life), VA (Veterans Affairs)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect